Missouri Department of Health Cruzan v. Director

Another side of the Cruzan question concerned advances in medical technology late in the twentieth century. Medical advances created machines that could perform essential respiratory and cardiac functions. In such situations, some argue, a clearer definition of "life" should be put forward--is the person a thinking, viable being, capable of surviving with no outside assistance? Countering that argument against the "quality" versus the mere "presence" of life are deeper religious beliefs; many argue that a supreme being is the giver of life, and as such should be the only one able to end it. In this case, however, Cruzan was assisted by a surgically implanted feeding tube. This measure, according to the American Medical Association, is classified as "medical treatment," and thus may be refused.

On the other hand, some medical ethicists argue that food and water comprise "basic care" and thus fall under the standard extension of kindness that humans must give one another. The Justice Department prepared a brief on the issue prior to the arguments presented for the Cruzan case, and conceded that current government policy allowed family members, in consultation with staff physicians, to decide whether or not to continue life-support measures for permanently incapacitated patients in veterans and army hospitals.

The Cruzan case also tackled the issue of "informed consent," or a person's ability to understand issues related to their medical care, and with that the granting of permission to doctors to carry them out. Yet this does not address the person who is unable to make decisions. One legal precedent in this area came with a decision made by the New York State Supreme Court in 1980, in which presiding Judge Sol Wachtler ruled that medical treatment could be withdrawn at the request of a patient's legal guardian, if the incapacitated person had made clear statement that he did not wish to be kept alive by heroic measures.